经腹经膈肌裂孔根治近侧部进展期胃癌

Transabdominal-hiatal approach of radical resection for advanced proximal gastric cancer

目的 评价经腹、膈肌裂孔途径行根治性切除累及食管下段近侧部进展期胃癌的可行性和有效性。方法 1999～ 2 0 0 1年针对 2 0例经腹、膈肌裂孔途径切除全胃和食管下段的病人 ,收集手术时间、术中失血量、ICU治疗时间、切除标本病理资料。结果与 2 0例经胸腹途径切除全胃和食管下段病人相比。结果 经腹、膈肌裂孔手术时间较短 ,术中失血量减少 ,ICU治疗时间短。结论 经腹、膈肌裂孔途径手术切除近侧部进展期胃癌是替代胸腹途径手术的合理手术方法 ,避免剖胸手术对病人的创伤。

Objective To evaluate a transabdominal-hiatal approach of resection for the advanced proximal gastric cancer with involvement of distal esophagus. Methods Twenty consecutive patients undergoing transabdominal-hiatal gastro-esophagectomy were studied.The data were collected prospectively with regard to operating time, operative blood loss, ICU stay, pathological details of specimen. Results were compared with those of the 20 previous patients for whom the same prospective information had been recorded following resection via the standard thoracoabdominal approach. Results The transabdominal-hiatal approach had a shorter operating time. It resulted in less blood loss and shorter ICU stay. Conclusion The transabdominal-hiatal approach to the resection of the advanced proximal gastric cancer is an effective and safe alternative to the standard thoracoabdominal technique.